| Entity Name: | CARLOS VIDALON, M.D., P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Feb 2002 (23 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P02000018751 |
| FEI/EIN Number | 260037493 |
| Address: | 2644 Oakbrook Drive, PLANTATION, FL, 33332, US |
| Mail Address: | 2644 Oakbrook Drive, Weston, FL, 33324, US |
| ZIP code: | 33332 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578822185 | 2012-05-16 | 2012-05-16 | 201 NW 82ND AVE, SUITE 504, PLANTATION, FL, 333247808, US | 201 NW 82ND AVE, SUITE 504, PLANTATION, FL, 333247808, US | |||||||||||||||||||||||||
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| Phone | +1 954-625-6778 |
| Fax | 9546256780 |
Authorized person
| Name | DR. CARLOS VIDALON |
| Role | OWNER |
| Phone | 9546256778 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| License Number | ME0021572 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NPI |
| Number | 1760480156 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| VIDALON CARLOS | Agent | 151 N Nob Hill Road, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| VIDALON CARLOS | Director | 151 N Nob Hill Road, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-26 | 2644 Oakbrook Drive, PLANTATION, FL 33332 | No data |
| CHANGE OF MAILING ADDRESS | 2020-04-14 | 2644 Oakbrook Drive, PLANTATION, FL 33332 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-04-14 | 151 N Nob Hill Road, 262, PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-04-11 | VIDALON, CARLOS | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-14 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-03 |
| ANNUAL REPORT | 2017-04-11 |
| ANNUAL REPORT | 2016-04-06 |
| ANNUAL REPORT | 2015-04-04 |
| ANNUAL REPORT | 2014-03-21 |
| ANNUAL REPORT | 2013-04-22 |
| ANNUAL REPORT | 2012-04-11 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
